Navigator Program Update

Covered California held a webinar on the preliminary recommendations for the Navigator program today. Navigators will provide both outreach and education and enrollment assistance to consumers, essentially functioning as hybrids of the in-person assistance and outreach and education programs currently in place.

Navigators will receive grants to conduct enrollment events, connect certified enrollment entities to consumers, and help individuals apply for Medi-Cal and Covered California. The goal of the program is to maximize enrollment by prioritizing assistance to areas with the largest concentrations of the uninsured.

Interested organizations may apply to be Navigators when the application opens in February. Grant awards will be selected in April and grant activities will run from July until the end of the year. Navigators are expected to facilitate enrollment in both the special enrollment and open enrollment periods.

There will be two categories of Navigator grants offered: targeted and regional. The targeted category will offer smaller grants for organizations working with hard-to-reach populations and those who have not been successfully targeted by other Covered California efforts. Regional grants will be for larger amounts and will go to collaborations between multiple organizations led by a primary entity. These projects should focus on reaching all of Southern, Central, or Northern California. Only one application can be submitted by each organization.

Nonprofit organizations, city governments, schools, FQHC clinics, tax preparers, unions, and attorneys may become Navigators, while county health departments, people licensed with Department of Insurance, such as agents, and others who would directly benefit from enrolling individuals cannot apply.

Covered California will award up to $5 million in Navigator grants in 2014. Funding decisions will emphasize cost-effectiveness, existing access to target markets, existing relationships with partnering organizations, cultural competency, and the robust infrastructure needed to achieve program goals. Grantees will be assessed by monthly benchmarks including enrollment statistics, enrollment events, and outreach efforts.

Current outreach and education grantees and certified enrollment entities can apply for the navigator program; however becoming a navigator organization will change the compensation for enrollment and outreach activities. Enrollment staff of Navigator entities will be trained as Certified Enrollment Counselors.

These recommendations are preliminary and are subject to change. Final recommendations will be provided to the Board November 21.